| NPI | 1679150064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LON SAMUEL HINCKLEY Oral And Maxillofacial Surgeon 607-427-6362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2021-04-14 |